ACUTE RENAL FAILURE AND NURSING CARE IN GERIATRIC PATIENTS IN THE INTENSIVE CARE UNIT AFTER HIP ARTHROPLASTY

Abstract

Aging is a complex and multifactorial process involving all organ systems. Decreased physiologic reserve, the presence of comorbidities and stressors related to surgery may lead to deterioration of the patient's general health status. In elderly patients, it is important to determine optimal perioperative treatments to minimize the adverse effects and complications related to the surgical procedure and to maximize recovery. For these reasons, it may be appropriate to follow the patient in the intensive care unit after the surgical procedure. With the increasing incidence of hip fractures in the elderly, the number of complications related to hip surgery is also increasing. One of these complications is Acute renal failure (ARF), which causes significant morbidity and mortality and patients need to be followed up in the intensive care unit. The fact that most of the patients are in the frail and pre-frailty patient group contributes to this situation. Therefore, the nurse's follow-up, treatment and care process is very important. With the right treatment and multidisciplinary approach to the patient, patients receive the best health care. The aim of this review is to provide appropriate nursing care in the case of ARF in the ICU after hip replacement surgery in geriatric patients.

Keywords

• Renal failure
• geriatric nursing
• hip arthroplasty
• intensive care nursing.

Geriatrik Hastalarda Kalça Protezi Ameliyatı Sonrası Yoğun Bakım Ünitesinde Gelişen Akut Böbrek Yetmezliği ve Hemşirelik Bakımı

Abstract

ÖZET Yaşlanma, tüm organ sistemlerini kapsayan kompleks ve çok faktörlü bir süreçtir. Fizyolojik rezervin azalması, ek hastalıkların varlığı ve ameliyata bağlı stresörler hastanın genel sağlık durumunun bozulmasına neden olabilir. Yaşlı hastalarda cerrahi işleme bağlı olumsuz etkileri ve komplikasyonları en aza indirmek, iyileşmeyi en üst düzeye çıkarmak için optimal perioperatif tedavileri belirlemek önemlidir. Bu nedenlerden dolayı hastanın cerrahi işlem sonrası yoğun bakım ünitesinde (YBÜ) takip edilmesi uygun olabilir. Yaşlılıkta kalça kırıklarının çok görülmesi ve insidansının artması ile birlikte kalça cerrahisine bağlı görülen komplikasyonların sayısı da artmaktadır. Bu komplikasyonlardan birisi Akut böbrek yetmezliği (ABY) olup önemli ölçüde morbidite ve mortaliteye sebep olduğundan hastaların YBÜ’ de izlenmeye gereksinimi vardır. Hastaların çoğunun kırılgan ve kırılganlık öncesi hasta grubunda olması bu duruma katkı sağlamaktadır. Bu nedenle hemşirenin takip, tedavi ve bakım süreci oldukça önemlidir. Hastaya uygulanacak doğru tedavi ve multidisipliner yaklaşımla hastalar en iyi sağlık hizmetini almış olur. Bu derlemenin amacı, geriatrik hastalarda kalça protezi ameliyatı sonrası YBÜ’de ABY gelişmesi durumunda uygun hemşirelik bakımını sunmaktır.

Keywords

• böbrek yetmezliği
• geriatri hemşireliği
• kalça artroplastisi
• yoğun bakım hemşireliği

References

1. Argaiz, E. R., Rola, P., Haycock, K. H., & Verbrugge, F. H. (2022). Fluid management in acute kidney injury: from evaluating fluid responsiveness towards assessment of fluid tolerance. European heart journal. Acute cardiovascular care, 11(10), 786–793.
2. Ayan, F. S., & Dağtekin, T. (2020). Geriatrik cerrahide güncel yaklaşımlar. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, (12), 460-474.
3. Bakı, E. D., Mazlum, M., Uçan, E., ve ark. (2021). Kalça protezi̇ yapilan yaşli hastalarin postoperati̇f renal fonksi̇yonlarinin retrospekti̇f i̇ncelenmesi̇. Kocatepe Tıp Dergisi, 22(3), 208-212. https://doi.org/10.18229/kocatepetip.651993
4. Balkan, A., ve Seki, Z. (2021). Total Kalça Protezi Uygulanan Bireylerin Taburculuk Sonrası Yaşadıkları Komplikasyonların Belirlenmesi. Black Sea Journal of Health Science, 4(2), 141-149.
5. Bannard‐Smith, J., Elrakhawy, M. M., Norman, G., Owen, R. K., Felton, T., & Dark, P. (2024). The efficacy, safety and effectiveness of hyperoncotic albumin solutions in patients with sepsis: a systematic review and meta-analysis. Journal of the Intensive Care Society, 25(3), 308-318. https://doi.org/10.1177/17511437241259437
6. Borges, F. K., Devereaux, P. J., Cuerden, M., et al. (2019). Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial. BMJ open, 9(9), e033150.
7. Braüner Christensen, J., Aasbrenn, M., Sandoval Castillo, L., et al. (2020). Predictors of Acute Kidney Injury After Hip Fracture in Older Adults. Geriatric Orthopaedic Surgery & Rehabilitation. 2020;11,2151459320920088.
8. Brothers, T., Strock, J., LeMasters, T., Pawasauskas, J., Reed, RC, & Al-Mamun, MA. (2022). Survival and recovery modeling of acute kidney injury in critically ill adults. SAGE Open Medicine. 2022;10.

9. Coşkun, A. S. (2020). Postoperatif Yoğun Bakıma Kabul Edilen Hastaların 1 Yıllık İncelenmesi. Acta Medica Nicomedia, 3(3), 105-108.
10. Cleto-Yamane, T. L., Gomes, C. L. R., Suassuna, J. H. R., & Nogueira, P. K. (2019). Acute Kidney Injury Epidemiology in pediatrics. Jornal brasileiro de nefrologia, 41(2), 275–283.
11. Çelik, F. ve Dağlı, R. (2021). Covid-19 pandemi döneminde kalça kırığı ameliyatı sonrasında yoğun bakıma alınan geriatrik hastaların risk faktörleri. Ahi Evran Medical Journal. https://doi.org/10.46332/aemj.944072
12. Çetin, S. (2018). Yoğun Bakımda Akut Böbrek Yetmezliği Olan Yetişkin Olgu Sunumu. Beslenme ve Diyet Dergisi, 46, 89-93.
13. Çetinkaya Eren, Ö., Büker, N., Tonak, HA ve Ürgüden, M. (2022). Total kalça protezi ameliyatı sonrası video yardımlı taburculuk eğitiminin etkisi: randomize kontrollü bir çalışma. Bilimsel Raporlar, 12 (1), 3067.
14. Deniz Kahvecioğlu, E., Öztürk, Y., & Ayhan, İ. (2023). Yoğun bakım ünitesinde akut böbrek hastalığı tanısı olan olgularda hemodiyaliz tedavisinin mortaliteye etkisi. Ege Tıp Bilimleri Dergisi, 6(1), 7
15. Dépret, F., Peacock, W. F., Liu, K. D., Rafique, Z., Rossignol, P., & Legrand, M. (2019). Management of hyperkalemia in the acutely ill patient. Annals of Intensive Care, 9(1). https://doi.org/10.1186/s13613-019-0509-8
16. Emmens, J. E., Ter Maaten, J. M., Matsue, Y., et al.(2022). Worsening renal function in acute heart failure in the context of diuretic response. European journal of heart failure, 24(2), 365–374.
17. Ferris, H., Brent, L., & Sorensen, J. (2022). Cost of hospitalisation for hip fracture findings from the Irish hip fracture database. Osteoporos Int, 33(5), 1057–1065.
18. Feyisa, D. W., Ayano, Y. M., Debelee, T. G., & Schwenker, F. (2023). Weak localization of radiographic manifestations in pulmonary tuberculosis from chest x-ray: a systematic review. Sensors, 23(15), 6781.
19. Fiaccadori, E., Sabatino, A., Barazzoni, R., et al. (2021). ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease. Clinical nutrition (Edinburgh, Scotland), 40(4), 1644–1668.
20. Gameiro, J., Marques, F., & Lopes, J. A. (2020). Long-term consequences of acute kidney injury: a narrative review. Clinical Kidney Journal, 14(3), 789-804.
21. Gameiro, J., Fonseca, J. A., Outerelo, C., & Lopes, J. A. (2020). Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies. Journal of clinical medicine, 9(6), 1704.
22. Ganta, A., Parola, R., Perskin, C. R., Konda, S. R., & Egol, K. A. (2021). Risk factors and associated outcomes of acute kidney injury in hip fracture patients. Journal of orthopaedics, 26, 115–118.
23. Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Tefera, Y. G., & Abegaz, T. M. (2019). Adverse effects and non-adherence to antihypertensive medications in university of gondar comprehensive specialized hospital. Clinical Hypertension, 25(1). https://doi.org/10.1186/s40885-018-0104-6
24. Gerçek, O., Yazar, V. M., Atik, M., & Topal, K. (2023). Factors affecting peroperative bleeding amount and need for blood transfusion in retropubic radical prostatectomy operation. Osmangazi̇ Journal of Medicine, 45(6).
25. Gerkuş, Ş., & Sivrikaya, S. K. (2020). Yoğun Bakım Ünitelerinde Gelişen Akut Böbrek Yetmezliği ve Hemşirelik Yönetimi. Yoğun Bakım Hemşireliği Dergisi, 24(2), 150-156
26. Haddad, B. I., Alhajahjeh, A. A., Altarazi, A., et al. (2023). Preoperative and intraoperative risk factors for acute kidney injury after hip fracture surgery: a cohort retrospective study. Renal failure, 45(1), 2223313.
27. Hadadi, A., Farrokhpour, H., Rashedi, S., et al. (2022). Long-term impact of the COVID-19 associated AKI: the relationship between kidney recovery and mortality in a 10-month follow-up cohort study. Kidney and Blood Pressure Research, 47(7), 486-491.
28. Hoste, E. A. J., Kellum, J. A., Selby, N. M., et al. (2018). Global epidemiology and outcomes of acute kidney injury. Nature reviews. Nephrology, 14(10), 607–625.
29. Kara, H., & Yılmaz, E. (2021). Geriatrik Cerrahide Ameliyat Sürecindeki Güncel Yaklaşımlar. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 4(3), 418-426.
30. Kellum, J. A., Romagnani, P., Ashuntantang, G., Ronco, C., Zarbock, A., & Anders, H. J. (2021). Acute kidney injury. Nature reviews. Disease primers, 7(1), 52.
31. Kung, C. W., & Chou, Y. H. (2023). Acute kidney disease: an overview of the epidemiology, pathophysiology, and management. Kidney research and clinical practice, 42(6), 686–699.
32. Küçükosman, G., Ayoğlu, H., 2018. Diagnosis and Classification of Acute Renal Injury in Intensive Care PatientsTurkiye Klinikleri J Nephrol-Special Topics. 2018;11(2):100-5
33. Levey, AS (2022). AKD'nin tanımlanması: AKI, AKD ve CKD'nin spektrumu. Nefron,146 (3), 302-305.
34. Liao, D., Deng, Y., Li, X., et al. (2023). The prognostic effects of the geriatric nutritional risk index on elderly acute kidney injury patients in intensive care units. Frontiers in medicine, 10, 1165428.
35. MacLaughlin, H. L., Friedman, A. N., & Ikizler, T. A. (2022). Nutrition in Kidney Disease: Core Curriculum 2022. American journal of kidney diseases: the official journal of the National Kidney Foundation, 79(3), 437–449.
36. Mbutiwi, F. I. N., & Sylvestre, M. (2023). Accounting for antihypertensive medications in Mendelian randomization studies of blood pressure: Methodological considerations in the Canadian Longitudinal Study on Aging. Journal of Hypertension, 41(8), 1281–1289. https://doi.org/10.1097/HJH.0000000000003464
37. McAlister, F. A., Molnar, A. O., Lau, C. K., Staplin, N., van Walraven, C., & Mazer, C. D. (2022). Accelerated surgery versus standard care in hip fracture (HIP ATTACK-1): A kidney substudy of a randomized clinical trial. American Journal of Kidney Diseases, 80(4), 484–492.e1. https://doi.org/10.1053/j.ajkd.2022.04.011
38. McDonald, J. S., McDonald, R. J., Williamson, E. E., Kallmes, D. F., & Kashani, K. (2017). Post-contrast acute kidney injury in intensive care unit patients: a propensity score-adjusted study. Intensive Care Medicine, 43, 774-784.
39. Mehta, R. L., Kellum, J. A., Shah, S. V., Molitoris, B. A., Ronco, C., Warnock, D. G., & Levin, A. (2021). Drug-induced nephrotoxicity: Prevention and management. Journal of the American Society of Nephrology, 32(6), 1387–1399. https://doi.org/10.1681/ASN.2021020123
40. Michael, G., Mercado, M. D., Dustin, K., Smith, D. O., & Guard, E. L., D. O. (2019). Acute kidney injury: Diagnosis and management. 100(11), 687–694.
41. Morrison, M. E., & Liu, K. D. (2022). Nursing Care in Acute Kidney Injury. Critical Care Clinics, 38(2), 219–230.
42. National Kidney Foundation (2023). Clinical Practice Guidelines for Acute Kidney Injury. https://www.kidney.org/professionals/guidelines
43. Neuen, B. L., Young, T., Heerspink, H. J., et al. (2019). SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. The lancet Diabetes & endocrinology, 7(11), 845-854.
44. Ostermann, M., Bellomo, R., Burdmann, E. A., et al. (2020). Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney international, 98(2), 294-309.
45. Povoroznyuk, V.V., Grygorieva, N.V., Kanis, J.A., et al. (2018). Epidemiology of Hip Fractures in Two Regions of Ukraine. J Osteoporos. , Article 7182873.
46. Rantalaiho, I., Gunn, J., Kukkonen, J. ve Kaipia, A. (2019). Kalça kırığı sonrası akut böbrek hasarı yaralanma, 50 (12), 2268-2271.
47. Shi, X.,Shen, Y., Yang, J., Du, W. ve Yang, J. (2021). Akut solunum yetmezliği olan yaşlı hastalarda geriatrik beslenme risk indeksinin mortalite ve kalış süresi ile ilişkisi: Retrospektif bir kohort çalışması. Kalp ve Akciğer, 50 (6), 898-905.
48. Tutupoho, RV, Asmaningsih, N. ve Prasetyo, RV (2021). Böbrek hastalığı olan çocuklarda yetersiz beslenmenin böbrek fonksiyonuyla ilişkisi. GSC Biyolojik ve İlaç Bilimleri, 17(3), 100-106.
49. Türker, PF. (2019). Böbrek hastalıklarında klinik beslenme yaklaşımı. Beslenme ve Diyetetik Dergisi, 46, 82-88.
50. Udeh, C. I., You, J., Wanek, M. R., et al. (2018). Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?. Perioperative Medicine, 7, 1-11.
51. Venkatakrishnaiah, N. K., Anandkumar, U. M., Wooly, S., Rajkamal, G., Gadiyar, H. B., & Janakiraman, P. (2022). Identification of factors contributing to the development of postoperative delirium in geriatric patients with hip fractures- a prospective study. Journal of Family Medicine and Primary Care, 11(8), 4785-4790. https://doi.org/10.4103/jfmpc.jfmpc_238_22
52. Vinson, A. J., Zanjir, W. R., Nallbani, M., et al. (2022). Predictors of hyperkalemia among patients on maintenance hemodialysis transported to the emergency department by ambulance. Kidney360, 3(4), 615-626. https://doi.org/10.34067/kid.0008132021
53. Wang, Y., & Bellomo, R. (2021). Acute kidney injury: diagnostic approaches and controversies. The Lancet, 398(10296), 1296-1308.
54. Wang, H., Cao, X., Li, B., Wu, H., Ning, T., & Cao, Y. (2023). Incidence and predictors of postoperative acute kidney injury in older adults with hip fractures. Archives of gerontology and geriatrics, 112, 105023.
55. Wang, J., Jiang, L., Ding, S., et al. (2023). Early Enteral Nutrition and Sepsis-Associated Acute Kidney Injury: A Propensity Score Matched Cohort Study Based on the MIMIC-III Database. Yonsei medical journal, 64(4), 259–268.
56. Wolfe, J. D., Wolfe, N. K., & Rich, M. W. (2020). Perioperative care of the geriatric patient for noncardiac surgery. Clinical Cardiology, 43(2), 127-136.
57. Xie, H.,Tang, S., Wei, L., &Gan, J. (2020). Geriatric nutritional risk index as a predictor of complication sand long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis. Cancercell international, 20, 1-12.
58. Yadav, S., Jahagirdar, A., Jamwal, P., et al. (2024). Retrospective study of anesthesia-related complications in elderly patients undergoing surgery. Journal of Pharmacy and Bioallied Sciences, 16(Suppl 3), S2572-S2575. https://doi.org/10.4103/jpbs.jpbs_253_24
59. Yuan, K., Zhu, S., Wang, H., et al. (2021). İskemik inmeli yaşlı erişkinlerde yetersiz beslenme ile uzun süreli mortalite arasındaki ilişki. Klinik Beslenme, 40 (5), 2535-2542.
60. Zeng, B., Liu, Y., Xu, J., et al.(2023). Future Directions in Optimizing Anesthesia to Reduce Perioperative Acute Kidney Injury. American journal of nephrology, 54(9-10), 434–450.
61. Zhang, Z., Ho, K. M., & Hong, Y. (2019). Machine learning for the prediction of volume responsiveness in patients with oliguric acute kidney injury in critical care. Critical care (London, England), 23(1), 112.
62. Zhao, B. C., Zhuang, P. P., Lei, S. H., et al. (2021). Pre-operative N-terminal pro-B-type natriuretic peptide for prediction of acute kidney injury after noncardiac surgery: a retrospective cohort study. European Journal of Anaesthesiology| EJA, 38(6), 591-599.